What is the first thought that crosses your mind? The baby shower filled with pink or blue? How will your partner react, and certainly friends and family? Depending on the relationship with your partner or life circumstances, this news may bring about any emotion fathomable from the human psyche. If this is your first pregnancy or one of many, where you are in life plays into your state-of-mind in that very moment. After coming to terms with being pregnant, you then realize that your world will be changing with this living being developing in your womb. This is the first of so much to follow, both physically and emotionally.
As an Obstetrician, I often find myself wondering how can I best help and care for my pregnant Mom-to-be? I feel the need to create this discourse with you, as it is not so easy to answer. As an Obstetrician, I would venture to say that most of my colleagues would do anything for that coveted, forth telling crystal ball. This crystal ball would allow me to see the future of what is to come for my Patient. Why, you may ask? Pregnancy is unpredictable. Will she carry this pregnancy to term and deliver a healthy baby? Will she leave my office and have a miscarriage before her next scheduled appointment? When you take care of a pregnant woman, you are watching over not one, but two living beings at every instance. This can be a daunting task when Mother Nature has thrown many curve balls our way in terms of maternal health and the risks and illnesses that come with pregnancy. When I see miscarriage, still birth, babies born with serious illnesses or even managing a traumatic birth where I nearly lose mother and baby in the labor process, I have to keep reminding myself, “Okay, we survived as a human race this far so there must be hope to get Mother and baby through this plight?” As an Obstetrician, it is the deep sadness we harbor every time there is nothing Medicine cannot do to change the outcome. The interplay of pregnancy physiology and that of the developing baby is often programmed from its very start. It is based on maternal health, genetics and whether all is developing according to plan. I often tell my Patients who experience early miscarriage, “even if I told you to stand on your head the entire pregnancy, it will not change the outcome of your pregnancy.” I want her to realize this miscarriage or any result of pregnancy is to no fault of her own, and please fight to not hold any guilt for anything that was out of your control.
So how then should I prepare each Pregnant Mother-to-be for pregnancy? What should I teach her and certainly warn her about? If I tell her about every possible infection or bad outcome, does this help her? Would knowing she can miscarry at any time or contract an infection to no fault of her own change her outcome? How does this help her? It is my goal to instill confidence in her as she crosses the path to motherhood, not to live in fear. If the worst happens to her, does telling her beforehand make it any better for her?
I want her to know no matter what path her pregnancy will follow; I am there every step of the way. She has expressed faith and trust in me and I want to provide the best care and guidance to manage her health and well-being, and that of her developing baby.
There is a very emotional side of pregnancy that must be acknowledged. At the first OB visit, there is either utter elation or tears of “what have I done, what will I do?” As the pregnancy progresses, there is a continuum of emotional responses that are very dependent on one’s awareness of her body, her life circumstance and family and financial support. If any one of these facets of her life falter, the wellness of she and baby are compromised. Anxiety and fear of pregnancy manifest as somatic complaints where every twitch, every pelvic cramp and every bit of swelling and fatigue bring about the question, “Is this normal or not?” We can most often reassure her of the things we know certain; however this is coupled with the fact that the medical care of a pregnancy has become very scientific and therefore cannot always be explained. We all know Science cannot always explain emotions and physical ailments. Obstetrics, the Practice of caring for those who are pregnant, has become quite the legal affair and Medicine has fallen prey to changing its Practice because of a pervasive litigious environment. The care and delivery of a newborn baby has been forced to rely on scientific measures that are not full proof and cannot be completely relied upon. It is the Obstetricians primary role to see Mother and baby through this process with the least risk of complication possible and our mission is always a happy and healthy mother and baby. The raw truth is that pregnancy is a time when a woman’s life is in the most danger and all is not foreseeable nor within our control. Medicine just isn’t good enough or perfect. Please do not misunderstand me, Medicine has made leaps and bounds in caring for pregnancies and we are able to perform amazing acts to save babies, but sadly it does not work every time and there are never guarantees. Among Obstetricians, there is a strong sense of duty to show each Patient we do care and will be steadfast in supporting each pregnant woman no matter her pregnancy outcome.
I ask you, “How can we best help and care for pregnant Moms-to-be given our discussion above?” I welcome you to visit the Greenville Women’s Clinic Blog and help me make connections to improve and acknowledge the needs you see or have had in your medical care or that of a loved one while being pregnant.